A4382 — Ostomy pouch, urinary, for use on faceplate, heavy plastic, each
HCPCS Level II A-code · short descriptor: “Urinary hvy plstc pch w/o fp”
- Code system
- HCPCS Level II
- Family
- A — Medical & surgical supplies, ambulance
- Medicare coverage status
- Special coverage instructions apply
- DMEPOS payment category
- Ostomy, tracheostomy & urological supplies
- Prior authorization
- Not on Medicare required-PA list
- Status
- Active (April 2026 HCPCS)
Prior authorization
Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.
A4382 Medicare fee schedule (April 2026)
Base (no modifier) Ostomy, tracheostomy & urological supplies
Medicare allowable ranges from $35.09 to $38.51 depending on state and rural status.
Former-CBA payment limits: ceiling $35.09 · floor $29.83
| State | Non-rural | Rural |
|---|---|---|
| AK | $35.43 | — |
| AL | $35.09 | — |
| AR | $35.09 | — |
| AZ | $35.09 | — |
| CA | $35.09 | — |
| CO | $35.09 | — |
| CT | $35.09 | — |
| DC | $35.09 | — |
| DE | $35.09 | — |
| FL | $35.09 | — |
| GA | $35.09 | — |
| HI | $37.91 | — |
| IA | $35.09 | — |
| ID | $35.09 | — |
| IL | $35.09 | — |
| IN | $35.09 | — |
| KS | $35.09 | — |
| KY | $35.09 | — |
| LA | $35.09 | — |
| MA | $35.09 | — |
| MD | $35.09 | — |
| ME | $35.09 | — |
| MI | $35.09 | — |
| MN | $35.09 | — |
| MO | $35.09 | — |
| MS | $35.09 | — |
| MT | $35.09 | — |
| NC | $35.09 | — |
| ND | $35.09 | — |
| NE | $35.09 | — |
| NH | $35.09 | — |
| NJ | $35.09 | — |
| NM | $35.09 | — |
| NV | $35.09 | — |
| NY | $35.09 | — |
| OH | $35.09 | — |
| OK | $35.09 | — |
| OR | $35.09 | — |
| PA | $35.09 | — |
| PR | $38.51 | — |
| RI | $35.09 | — |
| SC | $35.09 | — |
| SD | $35.09 | — |
| TN | $35.09 | — |
| TX | $35.09 | — |
| UT | $35.09 | — |
| VA | $35.09 | — |
| VI | $35.09 | — |
| VT | $35.09 | — |
| WA | $35.09 | — |
| WI | $35.09 | — |
| WV | $35.09 | — |
| WY | $35.09 | — |
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026.
Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%.
A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area
adjustments and non-continental rates can differ — verify with your DME MAC.
Common denial codes to watch
Related A-codes
Bill A4382 with confidence
MyMedi-AI scrubs whole claims against NCCI pairs, MUE limits, modifier rules, and PA flags before you submit — built for DME teams, no PHI stored on our servers.
Start free trial Run a CMS-0057-F readiness checkPrefer DIY compliance? Self-audit documentation kits for DME suppliers →